Effect Of Remote Ischemic Postconditioning On Serum Inflammatory Factors In Patients With Acute Cerebral Infarction

Object:To investigate the effect of remote ischemic postconditioning on serum inflammatory factors in patients with acute cerebral infarction.Methods:Selected the patients who were diagnosed as acute cerebral infarction from the department of neurology in the First Hospital of Jilin University from october 2016 to october 2017 as objects.Meeting the following conditions: the onset time within 72 h in the anterior circulation cerebral infarction;NIHSS score is 4 to 15(including 4 and 15);age 18 to 80;voluntarily participate in this study.Following conditions are ruled out: the patients who were exacerbated,subclavian arteries and upper extremity arteries are serious stenosis,other upper limb injuries,recently suffering from other neurological diseases,heart-related diseases,severe hypertension,other serious diseases,had a surgery recently.According to the patient's will,all patients were divided into the remote ischemic postconditioning(RIPost C)group and control group,the RIPost C group accepted routine therapy combined with double upper limbs ischemic postconditioning,namely bilateral upper limbs ischemia for 5 minutes / reperfusion for 5 minutes,a total of 5 cycles,twice a day for 1 week.Patients in the control group were given routine medication.We collected two groups patients serum three times,1 day before the RIPost C,1 day after the RIPost C and 7 days after the RIPost C,and detected serum levels of IL-1?,IL-2,IL-4,IL-6,IL-10,IL-17 A,TNF-? and IFN-? by cytometric bead array(CBA).Results:(1)The serum lever of IL-6 and TNF-? in patients with acute cerebral infarction are positively correlated with NIHSS score,but have no significant correlation with infarct volume(p>0.05);the serum lever of IL-1?,IL-2,IL-4,IL-10,IL-17 A and IFN-? have no significant correlation with infarct volume and NIHSS score(p> 0.05).(2)The serum levels of IL-2 in patients with acute cerebral infarction decreases gradually with time(p<0.05),but serum levels of IL-1?,IL-4,IL-6,IL-10,IL-17 A,TNF-? and IFN-? have no obvious change tendency with time(p> 0.05).(3)RIPost C(bilateral upper limbs ischemia for 5 minutes / reperfusion for 5 minutes)can upregulate the serum level of IL-2?IL-4 and IL-10 in patients with acute cerebral infarction(p<0.05).(4)RIPost C has a therapeutic effect on acute cerebral infarction.Routine therapy combine with RIPost C can improve the condition of patients(p<0.05).(5)RIPost C treatment is performed within 1st to 3rd after acute cerebral infarction,and the start of treatment is not significantly related to the therapeutic effect(p> 0.05),delayed RIPost C can still have therapeutic effects.Conclusions:(1)The serum level of IL-6 and TNF-? in patients with acute cerebral infarction is positively correlated with NIHSS score,the more serious the disease,the higher the level of serum IL-6 and TNF-?.The serum level of IL-2 decreases gradually with time,it may be related to the immunosuppression state after acute cerebral infarction.(2)RIPost C(bilateral upper limbs ischemia for 5 minutes / reperfusion for 5 minutes,5 cycles)is effective on acute cerebral infarction.Routine therapy combine with RIPost C can improve the condition of patients.RIPost C can improve the immune state of patients with acute cerebral infarction by upregulating the levels of IL-2,IL-4 and IL-10.